I haven’t been blogging nearly as much as I did five years ago, largely because my early blogging was all about trying to figure out “what the heck is up with the American healthcare system???” … it’s been two years since I had any new realizations.

Why would “figuring it out” make me stop blogging? Because as a change activist who’s also a public speaker, I’m gripped by one question: “What could be said that would make any difference?” There literally is no point in saying anything else. So once I realized how locked-in the system is, how intractable it is to change, I lost interest in flapping my gums and fingers.

But new things are in the wind, and it’s time to start pushing out those top learnings as foundation for what’s next. So, game on – in responses to two tweets, I got ornery:

I haven’t been blogging nearly as much as I did five years ago, largely because my early blogging was all about trying to figure out “what the heck is up with the American healthcare system???” and it’s now been two years since I had any new realizations. Here’s a summary of that, then some quick hits on recent and upcoming events.

No, wait – this part turned out long, so I’ll continue tomorrow with the “quick hits.” For today, here’s the baseline I reached two years ago.

My guest Jeanne Pinder is a former New York Times editor whose company Clear Health Costs has just won the Edward R. Murrow award for investigative journalism, for their contribution to the “Cracking the Code” series in New Orleans. [Read more…]

As I said recently, I’ve been writing less here for a number of reasons. One is that I’ve been asked to write on other sites. Another, a sobering factor, as that after years of study, I’ve concluded that the American healthcare system has tied itself in a fatal knot. The post shown here, on the Patient Power blog, is an example of both.

Update next day:

Here’s a million bucks’ worth of $100 bills. (That’s 100 packets of 100 $100 bills; each packet is 1/2″ thick.)

Here’s 100 times as much – a million hundred-dollar bills, $100 million:

Ten of those – a billion:

And a thousand of those – a trillion. Check out the little dude, who’s now in the bottom left corner:

And US healthcare is three times that size.

This helps me, for one, start to comprehend the magnitude of the problem. Something like that does not shrink willingly: lots of people would lose their jobs, including CEOs etc. That’s why I liken US healthcare to “a tumor that doesn’t know how to stop growing and killing its host.”

Go back up and take a look at the size of one million in this picture. Urk.

After years of study of healthcare around the world, listening to an immense number of arguments about what’s important and what works and doesn’t, it’s all summed up in this one picture. The Y axis is life expectancy; the X axis is cost. This graph has been tweeted furiously and often lately by health journalist @DanMunro. (More on him below.)

You can easily see that US health costs per capita are way, way, way out of whack with the rest of the world. And, the life expectancy we get for it is years worse than the countries that cost 2-3x less.

Some will argue bitterly that the facts aren’t relevant, or a hundred other arguments. I’ve lost interest in those arguments, because they’re all about rationale, and no rationale is worth a damn if the outcomes they’re trying to explain don’t match the rationale.